Crawford Nigel W, Barfield Charles, Hunt Rod W, Pitcher Helen, Buttery Jim P
SAEFVIC, Murdoch Children's Research Institute (MCRI), Melbourne, Victoria, Australia; Department of General Medicine, Royal Children's Hospital (RCH), Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2014 Apr;50(4):314-8. doi: 10.1111/jpc.12481. Epub 2013 Dec 27.
Preterm infants are at increased risk of vaccine preventable diseases. An audit in 2007 identified suboptimal immunisation status of preterm infants. The aim of this study was to complete the 'audit loop', reviewing preterm infants' immunisation status at a single tertiary paediatric hospital.
A retrospective follow-up immunisation audit was conducted at The Royal Children's Hospital, Melbourne, neonatal unit. The 'audit loop' included a preterm infants' reminder sticker and feedback of the original audit findings to Royal Children's Hospital health-care professionals. Immunisation status was determined using the Australian Childhood Immunisation Register record for all admitted preterm infants born <32 weeks gestation (July 2008-June 2009).
Conducted in March 2011, the median age of participants (n = 57) was 2.5 years (range 1.7-3.1 years). Forty-four per cent (25/57) had a history of chronic lung disease, 86% (49/57) were <1500 g and 42% (24/57) <28 weeks gestation. The majority (96% (55/57)) were up to date with routine immunisations at 12 months of age. There was a 2.4-fold increase, compared with the original audit, for receipt of the additional recommended hepatitis B vaccine at 12 months of age, as well as influenza vaccine in infants with chronic lung disease.
This study showed that a simple reminder combined with education strategies can improve vaccine delivery in special risk groups such as preterm infants.
早产儿罹患疫苗可预防疾病的风险增加。2007年的一项审计发现早产儿的免疫状况不理想。本研究的目的是完成“审计循环”,在一家三级儿科专科医院评估早产儿的免疫状况。
在墨尔本皇家儿童医院新生儿科进行了一项回顾性随访免疫审计。“审计循环”包括为早产儿张贴提醒贴纸,并将原始审计结果反馈给皇家儿童医院的医护人员。利用澳大利亚儿童免疫登记册记录,确定所有孕龄小于32周(2008年7月至2009年6月)入院的早产儿的免疫状况。
于2011年3月开展,参与者(n = 57)的中位年龄为2.5岁(范围1.7 - 3.1岁)。44%(25/57)有慢性肺病病史,86%(49/57)体重<1500克,42%(24/57)孕龄<28周。大多数(96%(55/57))在12月龄时完成了常规免疫接种。与原始审计相比,12月龄时额外推荐接种的乙型肝炎疫苗以及慢性肺病婴儿接种的流感疫苗的接种率提高了2.4倍。
本研究表明,简单的提醒与教育策略相结合可改善早产儿等特殊风险群体的疫苗接种情况。